Organization
ELITE AAOLESCENT CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARSHEEM CHAPMAN (CEO)
(910) 483-0324
Entity
Organization
Contact information
Practice address
20513 S HIGHWAY 301 NORTH, ST. PAULS, NC 28384
(910) 483-0234
(910) 483-2246
Mailing address
111 LAMON ST, 103, FAYETTEVILLE, NC 28301-4901
(910) 483-0324
(910) 483-2246
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6008828
—
NC
Enumeration date
09/23/2013
Last updated
09/23/2013
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